Provider Demographics
NPI:1205161940
Name:DRUSS, JODI ALLISON (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JODI
Middle Name:ALLISON
Last Name:DRUSS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 35TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-2122
Mailing Address - Country:US
Mailing Address - Phone:727-275-0997
Mailing Address - Fax:
Practice Address - Street 1:5012 35TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-2122
Practice Address - Country:US
Practice Address - Phone:727-275-0997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076388-11041C0700X
FLSW106191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical